Cervical cancer and Pap smear screening in Botswana: knowledge and perceptions

Abstract Background: Cervical cancer is the most common cancer in Botswana. Little is known about women's use of Papanicolaou (Pap) cervical smear tests. Aim: The study is to explore knowledge and beliefs of 30 women about cervical cancer and Pap smear tests using the Health Belief Model. Method: Women were recruited from all income levels using network sampling. Data were collected using a demographic questionnaire and semi‐structured interview guide. Data analysis included descriptive statistics for demographic data and content analysis for interview data. Findings: Knowledge of cervical cancer and the Pap smear test was inadequate among women with low incomes. Pap smear utilization was also limited among low‐income women. Of the 18 women who had at least one Pap smear test in their lifetime, eight (44%) had opportunistic testing as a result of having gynaecological symptoms. Twelve women (40%) had never had Pap smear tests. Major barriers to Pap smear screening included inadequate knowledge about Pap smear testing, providers’ negative attitudes, and limited access to doctors. Conclusion: The study has implications for health education and health policy and for nurses’ involvement in both.